Larres David T, Carr Walter, Gonzales Elizandro G, Hawley Jason S
Occupational Therapy Clinic, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859.
Department of Behavioral Biology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
Mil Med. 2016 May;181(5 Suppl):23-7. doi: 10.7205/MILMED-D-15-00152.
Traumatic brain injury (TBI) secondary to blast exposure is a common injury in the Global War on Terrorism, but little is known about the acute effects, recovery, pathophysiology, and neuropathology of blast-induced mild TBI (mTBI) in humans in a battlefield environment. Moreover, there is ongoing debate whether blast-induced mTBI is a different injury with a unique pathophysiology compared with mTBI from blunt trauma. In the case series reported here from Craig Joint Theater Hospital at Bagram Airfield, Afghanistan, 15 military service members with acute concussion/mTBI associated with blast exposure were evaluated within the first 24 hours after concussion and on days 2, 3, 5, and 7 with a Graded Symptom Checklist and a balance assessment, the Balance Error Scoring System. These data suggest that the recovery in blast-induced mTBI follows the pattern of recovery in sports-related concussion reported in The National Collegiate Athletic Association Concussion Study. In this retrospective case series, we provide the first description of the natural history of acute recovery in blast-induced mTBI, and we suspect, given our experience treating military service members, that further observations of the natural history of recovery in blast-induced mTBI will continue to mirror the natural history of recovery in sports concussion.
爆炸所致创伤性脑损伤（TBI）是全球反恐战争中常见的损伤，但对于战场环境下人类爆炸所致轻度TBI（mTBI）的急性效应、恢复情况、病理生理学及神经病理学，人们了解甚少。此外，对于爆炸所致mTBI与钝性创伤所致mTBI相比是否为具有独特病理生理学的不同损伤，目前仍存在争议。在阿富汗巴格拉姆空军基地克雷格联合战区医院报告的该病例系列中，15名与爆炸暴露相关的急性脑震荡/mTBI军人在脑震荡后的头24小时内以及第2、3、5和7天接受了分级症状清单和平衡评估（平衡误差评分系统）。这些数据表明，爆炸所致mTBI的恢复情况遵循美国大学体育协会脑震荡研究中所报告的运动相关脑震荡的恢复模式。在这个回顾性病例系列中，我们首次描述了爆炸所致mTBI急性恢复的自然病程，并且鉴于我们治疗军人的经验，我们怀疑对爆炸所致mTBI恢复自然病程的进一步观察将继续反映运动性脑震荡恢复的自然病程。
